Late Diagnosis of HIV Infection in Santiago, Chile. Characteristics and Risk Factors in Men

Abstract

Background: The ratio of men and women with AIDS in Chile in 2002–2006 was 7:1. Notification rate of HIV/AIDS in men during 2006 was 11.1 per 100.000 inhabitants. From 1990 to 2005 39.9% of all HIV infections were notified in AIDS stage (5,535). During the same period AIDS caused 5,288 fatalities. Late diagnosis of HIV (LD-HIV) is an important Public Health problem due to its high cost, morbidity and mortality. The aim of this study was to identify characteristics and risk factors related to LD-HIV, in order to define a risk profile and focus screening campaigns. Methods: A case control study was conducted at San José Hospital, a public hospital in Santiago, Chile. LD-HIV (case) was defined as a person with HIV infection and AIDS diagnosed in C3 stage within six months of its first HIV test. Control was a person in A1 stage. Data was retrieved from medical records and notification bulletin of patients who entered the HIV program from 1991 to 2007. Results: 152 patients were included, 86 cases and 66 controls. The mean age was 38.1 ± 9.4 vs. 30.9 ± 7.4 respectively (p = 0.0001). 77% had ≥12y of formal-education. 74.5% of cases were heterosexual vs. 25.5% (p = 0.003). 2.3% of cases vs. 10.6% had had sex with PLWHA (p = 0.004). 26.3% of cases vs. 13.8% were alcoholic (p = 0.027). 20% of all the subjects had used illicit drugs and 3.8% were IDU (nss). 33% of cases had PJP as definitory disease and only 4.2% had pulmonary TB. The mean LTCD4+ was 58 ± 49.9. 7.4% of cases died. The risk factors associated with LD-HIV were heterosexuality (OR = 2.6[1.1–6.6]95%) and age above 30 years (OR = 3.5[1.6–7.8]95%). Conclusions: heterosexuality and age above 30 years were identified as risk factors to LD-HIV. Alcoholism was also associated. It's important to focus screening campaigns to this group in our country.